Active NPI
Nanette Jolie Gauthier, MCD, CCC-SLP
- Speech-Language Pathologist
- Jacksonville Beach, FL
National Provider Identifier
1043334972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4231
- Practice address
- 333 1St St N
Suite 200
Jacksonville Beach, FL 32250-6945 - Phone
- (180) 094-0503
- Fax
- (188) 879-4503
- NPI assigned
- Mar 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4231 | LA | Primary |
Addresses
Primary practice location
333 1St St N
Suite 200
Jacksonville Beach, FL 32250-6945
Mailing address
521 Holly Moore Dr
Pineville, LA 71360-4536
Phone (337) 781-8419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4231 | LA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043334972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "521 HOLLY MOORE DR",
"city": "PINEVILLE",
"state": "LA",
"postal_code": "713604536",
"telephone_number": "337-781-8419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 1ST ST N",
"address_2": "SUITE 200",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "322506945",
"telephone_number": "180-094-0503",
"fax_number": "188-879-4503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUTHIER",
"first_name": "NANETTE",
"middle_name": "JOLIE",
"name_prefix": "Miss",
"credential": "MCD, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "4231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.